Influence of efflux pump inhibitors on the multidrug resistance of Helicobacter pylori

AIM:To evaluate the effect of efflux pump inhibitors (EPIs) on multidrug resistance of Helicobacter pylori (H. pylori).METHODS: H. pylori strains were isolated and cultured on Brucella agar plates with 10% sheep's blood. The multidrug resistant (MDR) H. pylori were obtained with the inducer chloramphenicol by repeated doubling of the concentration until no colony was seen, then the susceptibilities of the MDR strains and their parents to 9 antibiotics were assessed with agar dilution tests. The present study included periods before and after the advent of the EPIs, carbonyl cyanide m-chlorophenyl hydrazone (CCCP), reserpine and pantoprazole), and the minimum inhibitory concentrations (MICs) were determined accordingly. In the same way, the effects of 5 proton pump inhibitors (PPIs), used in treatment of H. pylori infection, on MICs of antibiotics were evaluated.RESULTS: Four strains of MDR H. pylori were induced successfully, and the antibiotic susceptibilities of MDR strains were partly restored by CCCP and pantoprazole, but there was little effect of reserpine. Rabeprazole was the most effective of the 5 PPIs which could decrease the MICs of antibiotics for MDR H. pylori significantly.CONCLUSION: In vitro, some EPIs can strengthen the activities of different antibiotics which are the putative substrates of the efflux pump system in H. pylori.

Efflux pump gene hefA of Helicobacter pylori plays an important role in multidrug resistance

AIM: To determine whether efflux systems contribute to multidrug resistance of H pylori. METHODS: A chloramphenicol-induced multidrug resistance model of six susceptible H pylori strains (5 isolates and H pylori NCTC11637) was developed. Multidrug-resistant (MDR) strains were selected and the minimal inhibitory concentration (MIC) of eryth-romycin, metronidazole, penicillin G, tetracycline, and ciprofloxacin in multidrug resistant strains and their parent strains was determined by agar dilution tests. The level of mRNA expression of hefA was assessed by fluorescence real-time quantitative PCR. A H pylori LZ1026 knockout mutant (ΔH pylori LZ1026) for (puta-tive) efflux protein was constructed by inserting the kanamycin resistance cassette from pEGFP-N2 into hefA, and its susceptibility profiles to 10 antibiotics were evaluated. RESULTS: The MIC of six multidrug-resistant strains (including 5 clinical isolates and H pylori NCTC11637) increased signifi cantly (≥ 4-fold) compared with their parent strains. The expression level of hefA gene was significantly higher in the MDR strains than in their parent strains (P = 0.033). A H pylori LZ1026 mutant was successfully constructed and the ΔH pylori LZ1026 was more susceptible to four of the 10 antibiotics. All the 20 strains displayed transcripts for hefA that con-fi rmed the in vitro expression of these genes.CONCLUSION: The efflux pump gene hefA plays an important role in multidrug resistance of H pylori.

Plant-derived secondary metabolites as the main source of efflux pump inhibitors and methods for identification

The upsurge of multiple drug resistance(MDR)bacteria substantially diminishes the effectiveness of antibiotic arsenal and therefore intensifies the rate of therapeutic failure.The major factor in MDR is efflux pump-mediated resistance.A unique pump can make bacteria withstand a wide range of structurally diverse compounds.Therefore,their inhibition is a promising route to eliminate resistance phenomenon in bacteria.Phytochemicals are excellent alternatives as resistance-modifying agents.They can directly kill bacteria or interact with the crucial events of pathogenicity,thereby decreasing the ability of bacteria to develop resistance.Numerous botanicals display noteworthy efflux pumps inhibitory activities.Edible plants are of growing interest.Likewise,some plant families would be excellent sources of efflux pump inhibitors(EPIs)including Apocynaceae,Berberidaceae,Convolvulaceae,Cucurbitaceae,Fabaceae,Lamiaceae,and Zingiberaceae.Easily applicable methods for screening plant-derived EPIs include checkerboard synergy test,berberine uptake assay and ethidium bromide test.In silico highthroughput virtual detection can be evaluated as a criterion of excluding compounds with efflux substrate-like characteristics,thereby improving the selection process and extending the identification of EPIs.To ascertain the efflux activity inhibition,real-time PCR and quantitative mass spectrometry can be applied.This review emphasizes on efflux pumps and their roles in transmitting bacterial resistance and an update plant-derived EPIs and strategies for identification.

Role of MexA-MexB-OprM Efflux Pump System in Chronic Pseudomonas Aeruginosa Pulmonary Infection in Mice

In order to investigate the role of the MexA-MexB-OprM efflux pump system in the pathogenesis of Pseudomonas aeruginosa(PA)-induced pulmonary infection,pulmonary infection models were established by intratracheal injection of K767(wild type),nalB(MexA-MexB-OprM up-regulated mutant),and △m exB(knockout) strains,separately.All mice were treated with Meropenem(intraperitoneal injection,100 mg/kg body weight,twice every day),and strain-related pathology,bacteria count,cytokine level,myeloperoxidase(MPO,indicator of neutrophil recruitment) activity,and macrophage inflammatory protein-2(MIP-2) expression were evaluated at early(3rd day post-infection) and late(7th and 14th day post-infection) stages of infection.E-test showed that △mexB was more significantly sensitive to panipenan(ETP),meropenem(MP) and imipenem(IP) than K767 and nalB strains.There was no significant difference in sensitivity to cefepime(TM) among the three stains.In contrast to the K767 and nalB groups,the △ mexB group showed decreased bacteria burden over time and less extensive pathological change.Additionally,MPO activity and levels of inflammatory cytokines(IL-1b,IL-12,and TNF-α) were increased at the early stage(day 3) and decreased at the later stage(day 14).Serum MIP-2 expression level was steadily increased in all three groups from early to late stages,but significantly higher in △m exB group than in K767 and nalB groups(P<0.05).In conclusion,the MexA-MexB-OprM efflux pump system might play an important role in PA-induced chronic pulmonary infection.High expression of the MexA-MexB-OprM efflux pump could increase antibacterial resistance and promote infection.

Characterization and frequency of antibiotic resistance related to membrane porin and efflux pump genes among Acinetobacter baumannii strains obtained from burn patients in Tehran, Iran

Objective: To explore the characterization and frequency of antibiotic resistance related to membrane porin and efflux pump genes among Acinetobacter baumannii (A. baumannii) strains obtained from burn patients in Tehran, Iran. Methods: In this cross-sectional descriptive study, 100 strains of A. baumannii isolated from burn patients visiting teaching hospitals of Tehran were collected from January 2016 to November 2017. After A. baumannii strains were confirmed, antimicrobial susceptibility testing was done via Kirby-Bauer disc diffusion method according to the Clinical and Laboratory Standards Institute guidelines. PCR amplification was performed for detection of β-lactamase adeR, OprD, adeS genes among A. baumannii strains. Results: All isolates (100%) were resistant to ceftazidime, cefotaxime, cefepime, ciprofloxacin, and piperacillin, and most isolates indicated high resistance (95%-97%) to meropenem, imipenem, gentamicin, ceftriaxone, trimethoprim-sulfamethoxazole, piperacillin-tazobactam, amikacin, and tetracycline. The most effective antibiotic against A. baumannii isolates was colistin (97% sensitivity), followed by tigecycline. The frequency of OprD, adeS, and adeR genes were 98%, 91%, and 77%, respectively. Conclusions: This study shows that the majority of A. baumannii isolates are highly resistant to the antibiotics most commonly used in burn patients. Also, high distribution of OprD and adeRS genes may be responsible for the observed resistances among A. baumannii isolates that demonstrate the possible role of both efflux pumps in simultaneous of carbapenemase production during antibiotic resistance.

Mechanisms Efflux Pumps of <i>Acinetobacter baumannii</i>(MDR): Increasing Resistance to Antibiotics

Acinetobacter baumannii has greatly increased its degree of resistance to become multidrug resistant (MDR) over the past 30 years and is on the red line of the most widely replicated bacteria according to World Health Organization (WHO). The efflux pumps are the main cause for the increasing antibiotic resistance of A. baumannii originated from nosocomial infection. The progressive resistance of A. baumannii even on the recent drugs (tigecycline and fosfomycin) reduces to very effective antibiotic scale. With attention focused on MDR and pan-drug-resistant (PDR) in A. baumannii multiple works on efflux pumps chemical inhibitor (NMP, PAβN, omeprazole, verapamil, reserpine, CCCP) are still in progress. Certain inhibitors from plants (Biricodar and timcodar, Falvone, Mahonia, Dalea versicolor, Lycopus europaeus, and Rosmarinus officinalis) have the capability to have such compounds according to their very significant synergistic effect with antibiotics. In this review we focused on the growth of antibiotic resistance to explain the mechanism of efflux pumps into these different super families and a comprehensive understanding of the extrusion, regulation and physiology role of drug efflux pumps in the essential development of anti-resistivity drugs. We recapitulated the evolution of the work carried out in these fields during the last years and in the course of elaboration, with the aim of increasing the chances of decreasing bacterial resistivity to antibiotics.

Drug interactions of dipeptidyl peptidase 4 inhibitors involving CYP enzymes and P-gp efflux pump

Dipeptidyl peptidase 4(DPP4) inhibitors are oral antidiabetic drugs approved to manage type 2 diabetes mellitus. Saxagliptin is a substrate of CYP3A4/5 enzymes while other DPP4 inhibitors such as sitagliptin, linagliptin, gemigliptin and teneligliptin are weak substrates of CYP3A4. DPP4 inhibitors have also been identified as substrates of P-gp. Hence, the drugs inhibiting or inducing CYP3A4/5 enzymes and/or P-gp can alter the pharmacokinetics of DPP4 inhibitors. This review is aimed to identify the drugs interacting with DPP4 inhibitors. The plasma concentrations of saxagliptin have been reported to be increased significantly by the concomitant administration of ketoconazole or diltiazem while no significant interactions between various DPP4 inhibitors and drugs like warfarin, digoxin or cyclosporine have been identified.

Antibacterial activity and inhibition against Staphylococcus aureus NorA efflux pump by ferulic acid and its esterified derivatives

Objective:To evaluate the inhibitory activity of ferulic acid and four of its esterified derivatives(methyl,ethyl,propyl,and butyl)against resistance mechanisms in Staphylococcus aureus strains.Methods:Ferulic acid derivatives were obtained by esterification with methanol,ethanol,propanol,and butanol,and then characterized by hydrogen and carbon-13 nuclear magnetic resonance analysis.The minimum inhibitory concentrations(MIC)of ferulic acid and its esterified derivatives,ethidium bromide,and norfloxacin were obtained using the microdilution test,while the efflux pump inhibition test was conducted by examining reduction in the MICs of norfloxacin and ethidium bromide.Molecular docking was also carried out using the Schrodinger Suite 2015 molecular modeling software.A three-dimensional model of NorA efflux pump was generated using I-TASSER.The best scoring model was used as a receptor for ligand-receptor docking.Results:The methyl and butyl ester derivatives did not demonstrate significant antimicrobial activity.However,a significant synergic effect was evidenced when norfloxacin was combined with the ethyl and propyl esterified derivatives.The docking study demonstrated favorable energy of interaction between ferulate derivatives and NorA,and amino acid residues TYR57,TYR58,and LEU255 were present commonly in stabilizing all complexes.The PCA analysis corroborated the docking hypothesis that the lipophilic character and hydrogen bond interactions were the most relevant characteristics involved with NorA inhibitors.The pharmacokinetic parameters of ferulic acid derivatives showed good ADMET properties,demonstrating that they can be easily absorbed and have no effect or inhibit the cytochrome P450 enzyme complex,revealing their potential as drug candidates.Conclusions:This study provides strong evidence that the molecular basis for this activity is potentially due to the NorA efflux pump.

Mutational and Phylogenetic Analysis of <i>nfxB</i>Gene in Multidrug-Resistant Clinical Isolates of <i>Pseudomonas aeruginosa</i>Hyperexpressing MexCD-OprJ Efflux Pump

The present study focused on MexCD-OprJ efflux pump and its regulatory gene nfxB in multidrug resistant (MDR) clinical isolates of Pseudomonas aeruginosa collected from Kerala, South India. Semi-quantitative reverse transcription-PCR technique was employed to detect hyperexpression of the efflux pump gene, mexD. Amplicons from nfxB gene of isolates hyperexpressing the efflux pump were sequenced for mutational and phylogenetic analysis. Among 29 isolates of MDR P. aeruginosa, increased mexD transcription was detected in 10.3% of the isolates when compared with P. aeruginosa reference strain, PAO (MTCC-3541). Various synonymous and non-synonymous mutations in nfxB regulatory gene sequences were detected. Notably, mutations detected in the strains designate Pa6 and Pa7 have been found to be novel and are hitherto unreported in GenBank data base. The genetic divergence and homogeneity of the nfxB regulatory gene sequences of mexCD-oprJ operon were clearly apparent in the phylogram generated employing similar sequences retrieved from the public database.

Detection of the Mex Efflux Pumps in <i>Pseudomonas</i><i>aeruginosa</i>by Using a Combined Resistance-Phenotypic Markers and Multiplex RT-PCR

The aim of this study was to detect the expression of 4 clinically-important efflux pumps in the Resistance-Nodulation-Cell Division (RND) family including MexAB-OprM, MexXY, MexCD-OprJ and MexEF-OprN in Pseudomonas aeruginosa using a combination of resistance-phenotypic markers and multiplex RT-PCR (mRT-PCR). The antibiotic substrates specific for each Mex systems were used as phenotypic markers including carbenicillin, MexAB-OprM, erythromycin, MexCD-OprJ, norfloxacin and imipenem, MexEF-OprN and gentamicin, MexXY-OprM. The methods were validated with reference strains with known genotypes of the Mex systems and the potential applicability in clinical practice was tested with clinical isolates. The results for the reference strains support that the combination of resistance phenotype and mRT-PCR is a potential-attractive method for diagnosis of efflux-mediated resistance in P. aeruginosa. Further development to make it more practical for clinical use and study in a larger number of clinical isolates is required.

Detection of oqxA and oqxB efflux pump genes among nosocomial coliform bacilli:An observational cross-sectional study

Objectives:To identify and test the antibiotic susceptibility of nosocomial coliform bacilli and investigate the presence of oqxA and oqxB genes among the multidrug-resistant(MDR)phenotypes.Methods:One hundred and twenty different healthcare-associated infection samples were collected.Coliform bacilli were isolated,identified by conventional methods,and then antibiotic susceptibility tests were done using the VITEK2 system and disk diffusion methods.OqxAB operon was identified using a conventional PCR-based technique.oqxA and oqxB genes were compared between MDR Klebsiella pneumonia(K.pneumonia)phenotypes and MDR Escherichia coli(E.coli)phenotypes.Besides,oqxAB operons were compared between phenotypes of K.pneumonia and E.coli isolates.Results:Seventy coliform bacilli were isolated with the predominance of K.pneumonia and E.coli.Besides,82.1%of K.pneumonia strains and 53.3%of E.coli isolates were MDR phenotypes.Significant more oqxB genes alone were found in MDR E.coli than that in MDR K.pneumoniae phenotypes(χ^(2)=10.160,P=0.003).OqxAB operon was significantly more in MDR phenotypes of E.coli than that in the susceptible phenotypes(P<0.001).There was significantly less of this operon in susceptible E.coli isolates than that in susceptible K.pneumoniae isolates(P<0.001).OqxAB positive isolates that were also resistant to fluoroquinolones,tetracycline,trimethoprim,and chloramphenicol,most probably suggested functional pumps.Conclusions:MDR coliform bacilli are strongly implicated in healthcare-associated infection.Attention should be paid to the presence of oqxAB pump,as an important mechanism in the development of resistance against many antimicrobials because it contributes to co-resistance with other categories;therefore,this pump could be a good target for efflux pump inhibitors.

AcrAB Efflux Pump in Fluoroquinolone Resistant Salmonella gallinarum Induced by Ciprofloxacin Selective Pressure

Salmonella gallinarum has shown multiple drug resistance(MDR),especially high level fluoroquinolone(FQ)resistance in recent years.To determine whether the active efflux system was responsible for high-level FQ resistance,this research studied AcrAB efflux pump in Salmonella gallinarum on molecular level.The resistant strains were induced by standard strain C79-13 with ciprofloxacin in vitro.With carbonylcyanide-p-chlorophenyl hydrazone(CCCP)as an energy inhibitor,efflux inhibition test initially showed the potential impact of efflux pump on drug resistance.Sequence analysis of acrA gene indicated that gene mutation of AcrAB efflux pump was not definitely associated with MDR and drug resistance level of Salmonella gallinarum.Detected by competitive RT-PCR,the mRNA expression of acrA and acrB genes in the resistant strains significantly increased(p<0.01)compared with that of the control strain C79-13.The mRNA expression level of acrB gene(increased from 1.6-to 2.9-folds)was consistent with that of acrA gene(increased from 1.6-to 2.8-folds),which increased with the drug resistance level.However,gene mutation of acrA gene showed no correlation with its mRNA expression level,indicating that gene mutation did not affect the expression of AcrAB pump itself.The results suggested that the overexpression rather than the gene mutation of AcrAB efflux pump was an important factor causing the high level drug resistance of Salmonella gallinarum.

大肠埃希菌AcrAB-TolC外排泵表达水平调控机制的研究进展

AcrAB-TolC外排泵的过量表达是引起大肠埃希菌多重耐药的主要原因。AcrAB-TolC外排泵的表达水平主要受其正向调节因子、负向调节因子以及环境中的化学物质等调节。本文综述了近年来AcrAB-TolC外排泵调控因子方面的研究进展。

志贺菌主动外排泵acrAB-tolC及调控基因marOR突变与耐药的关系

目的:研究志贺菌的耐药状况,检测临床分离志贺菌主动外排泵acrAB-tolC基因及调控基因marOR的突变情况,并探讨其与耐药性的关系。方法:对159株临床分离的志贺菌进行四环素、氯霉素、氨苄青霉素、庆大霉素、诺氟沙星、复方新诺明6种药物的药敏试验和有机溶剂耐受试验,对其acrAB-tolC基因和marOR基因进行聚合酶链反应(PCR)扩增,并进行限制性内切酶酶切与单链构象多态性(SSCP)分析。结果:159株临床分离的志贺菌属细菌筛选出4株敏感株、18株耐单药株和137株耐多药株,耐多药率为86.2%(137/159);159株中有122株对有机溶剂耐受,耐受率为76.7%(122/159);159株均扩增出acrAB-tolC基因和marOR基因,未发现基因缺失株;单链构象多态性分析,155株耐药菌株中,marOR基因的突变率为17.4%,acrA基因的突变率为5.8%,acrB基因的突变率为3.9%,tolC基因的突变率为2.6%;4株敏感株未发现marOR、acrA、acrB和tolC基因突变。结论:临床分离的志贺菌耐多药率和有机溶剂耐受率均较高,且存在较高的marOR基因突变率。

细菌AcrAB-TolC型外排泵中AcrA蛋白的进化分析

研究不同耐药细菌AcrAB-Tolc型外排泵中关键蛋白AcrA的序列,针对其保守及非保守氨基酸残基进行该类蛋白的进化分析,构建蛋白进化树。收集来源于不同细菌的已知序列的AcrA蛋白,去除冗余并进行序列比对之后,根据其序列比对结果的相似性、氨基酸残基的保守性研究其进化特征。结果表明,不同细菌的AcrA蛋白部分氨基酸残基具有高度的保守性,这与其实现生物学功能有关,非保守区域是主要的进化区域。可为不同菌株的进化提供参考,同时为以AcrAB-Tolc型外排泵为靶标的新药研究提供相关数据。

阿米卡星诱导对大肠埃希氏菌耐药性及生物被膜和外排泵活性的影响

为研究亚抑菌浓度阿米卡星诱导对大肠埃希氏菌敏感菌株耐药性、生物被膜形成能力及外排泵活性的影响,采用微量肉汤稀释法测定阿米卡星对6株菌株的最小抑菌浓度(MIC),并以0.5 MIC作为初始诱导浓度进行诱导,每隔5 d重新测定阿米卡星MIC,并调整诱导浓度,共计30 d,最后将诱导第30天菌株进行无药物压力稳定培养5 d,保存各诱导菌株及无药传代菌株共计210株,测定各诱导菌株药物敏感性、生物被膜形成能力及部分菌株外排泵活性变化。结果发现,随着诱导天数的增加,阿米卡星对6株分离菌株MIC逐渐升高,诱导菌株耐药性不断增强,其对诱导第30天菌株的MIC值为诱导前的8~32倍;经过5 d无药培养后,MIC测定结果与第30天基本保持一致;诱导后的菌株中,强成膜能力菌株占总数的5%,中成膜能力菌株为56.7%;以每5 d的生物被膜形成量平均值与原菌相比,结果发现,所有诱导菌株生物被膜形成量均显著增加(P<0.01),表明亚抑菌浓度阿米卡星诱导可促进大肠埃希氏菌生物被膜的形成;无药稳定培养5 d的菌株与诱导第30天菌株相比,生物被膜形成能力基本保持不变。荧光探针测定外排泵结果显示,诱导菌株外排泵活性显著受到抑制。以上研究结果表明,阿米卡星诱导促进菌株生物被膜的形成,抑制外排泵活性,使菌株的耐药性增强,研究结果可为氨基糖苷类药物用药提供理论依据。

河曲马源大肠杆菌耐药相关基因检测及外排泵抑制剂对其生物被膜的影响

[目的]了解河曲马源大肠杆菌的耐药情况,为兽医临床合理使用抗菌药物提供基础理论指导。[方法]采用细菌形态学、革兰染色镜检、16S rDNA序列分析等方法进行细菌分离鉴定。采用微量肉汤稀释法和PCR扩增方法对分离鉴定的大肠杆菌进行抗菌药物敏感性试验及耐药基因、整合酶基因、外排泵基因携带情况检测。同时,采用改良结晶紫半定量方法进行生物被膜形成能力测定。利用棋盘法测定13种外排泵抑制剂与多西环素联用对生物被膜的清除作用。[结果]分离株在伊红-美蓝琼脂培养基上为具有绿色金属光泽的紫黑色菌落,在大肠杆菌/大肠菌群显色培养基上为蓝色菌落,革兰染色镜检可见粉红色短杆状细菌。经16S rDNA测序比对与大肠杆菌高度相似的分离株为64株。64株大肠杆菌分离株对酰氨醇类、磺胺类及利福霉素类药物耐药率相对较高并出现多重耐药菌株,其中20.31%(13/64)表现出对5类抗菌药物耐药;检测到21个耐药基因、1个整合酶基因及6个外排泵基因为阳性;整合酶基因intl 1检出率为89.06%。生物被膜形成能力为强、中、弱及无成膜能力的大肠杆菌分别为8(12.50%)、34(53.13%)、20(31.25%)和2(3.12%)株。外排泵抑制剂与多西环素联合能增强对生物被膜的清除能力。[结论]河曲马源大肠杆菌耐药较为严重,应进一步加强青海省河南蒙古族自治县赛马的用药监管力度,减少或避免多重耐药菌株的出现及耐药性广泛传播。

细菌外排泵功能及抑制机制的研究进展

近年来,由于抗生素在临床上的不规范使用,细菌耐药率呈快速增长趋势,显著增加临床的抗感染治疗难度。对于耐药菌而言,外排蛋白基因占所有转运蛋白基因的6%~18%。因此,由外排基因编码的外排泵是细菌产生多重耐药的重要机制之一。最新研究结果表明,外排泵抑制剂是通过抑制外排泵研发针对性抗生素的新治疗靶点,因此,为解决细菌多重耐药性问题,研发外排泵抑制剂势在必行。鉴于此,本研究对细菌外排泵的功能和抑制机制进行综述,以期为临床合理用药及医院感染防控提供帮助与指导。

穿心莲内酯对金黄色葡萄球菌外排系统的抑制作用

为探究穿心莲内酯(AP)对金黄色葡萄球菌(S.aureus)外排系统的抑制作用,本试验采用微量肉汤稀释法和棋盘法检测AP与抗菌药物的联合抑菌作用,荧光分光光度法检测AP对S.aureus体内环丙沙星蓄积量的影响,PCR和实时荧光定量PCR方法检测S.aureus外排泵基因的携带情况和AP对S.aureus外排泵基因转录水平的影响。结果显示,AP与环丙沙星具有协同作用;AP与S.aureus作用12 min时,能极显著提高菌体内环丙沙星的蓄积量(P<0.000 1);外排泵基因norA、norB、norC、sepA、mepA和mdeA同时携带的比例为24.1%,norB基因的检出率最高,为87.4%;AP作用后,S.aureus外排泵基因转录水平均极显著下降(P<0.001或P<0.000 1),其中norB在AP浓度达到256和512μg/mL时下降幅度最大,较空白对照降低91%(P<0.001),提示AP可通过抑制外排泵基因的表达来增强S.aureus对药物的敏感性。本试验从耐药表型和基因表达水平来确认AP是否可成为一种潜在的外排泵抑制剂,为解决S.aureus耐药问题提供新的思路。

苯扎溴铵及土霉素诱导大肠埃希菌耐药株AcrAB-TolC外排泵调控基因变异研究

为探讨细菌对消毒剂和抗菌药物耐药性之间的相关性,本试验分别用亚抑菌浓度苯扎溴铵和土霉素分别对大肠埃希菌质控菌ATCC25922进行体外诱导,测定诱导前后最小抑菌浓度(MIC)的变化;并对诱导后菌株外排泵调控基因acr R、mar A、sox S、rob进行PCR扩增和测序,检测其突变情况。结果显示,菌株经苯扎溴铵和土霉素诱导后对苯扎溴铵和土霉素均产生了耐药性,且诱导后的菌株有相同基因的同一位点发生突变,mar A、sox S所编码的氨基酸也有同一位点发生突变,提示大肠埃希菌对苯扎溴铵及土霉素的交叉耐药与调控基因位点的突变有一定相关性。